Quality Payment Specialist

Reposted 7 Days Ago
Be an Early Applicant
Fairbanks, AK, USA
In-Office
36-58 Hourly
Entry level
Healthtech
The Role
Oversees CMS Quality Payment Programs, Alternative Payment Models, and other value-based reimbursement initiatives. Monitors regulatory changes, incentive metrics, financial impacts, and performance dashboards; develops workflows, action plans, education, and cross-functional project plans. Partners with Finance, Quality, Clinical Informatics, IT, providers, and leadership on regulatory submissions, EMR changes, reporting, and strategies to maximize incentives and reduce penalties.
Summary Generated by Built In
Overview

The core responsibility of this position is the oversight of FHP’s performance under CMS’s Quality Payment Program (QPP), Alternative Payment Models (APMs), and other regulatory value based programs. Provides oversight to the incentive payment programs impacting both eligible providers (EP) and eligible hospitals (EH). Establishes system-wide processes that meets requirements and monitors performance on the incentive metrics. Collaborates with Finance and Quality Departments for attestation or submission to the appropriate governmental agencies. Facilitates ongoing strategy and education on meeting the requirements of QPPs to all impacted employees, providers, and leadership.


Qualified applicants must reside in the local area or have confirmed plans to relocate prior to their start date.


Pay & Benefits:

  • Compensation: $36.44 to $58.30 hourly wage based on experience and education
  • Incentive: $20,000
  • Relocation Assistance: up to $7,500 Relocation Assistance
  • Temporary Housing: 90 Days Temporary Housing Provided
  • Additional Pay: Shift Differential, Annual Increases, Paid Time Off
  • Benefits: medical, vision, dental, 401k with employer match
  • Education Benefits: FHP Tuition Assistance, Student Loan Forgiveness
  • Other Benefits: Onsite Gym, Wellness Programs, Discount programs
  • Shifts Available: Full Time, Exempt

About Fairbanks Memorial HospitalFairbanks Memorial Hospital is a non-profit facility owned by the Greater Fairbanks Community Hospital Foundation. A Joint Commission-accredited facility with 152 licensed beds, Fairbanks Memorial Hospital is the primary referral center for residents of Alaska's interior. We have a strong patient to nurse ratio and a culture of Shared Leadership. In addition to our exceptional clinical environment, our location offers incomparable lifestyle rewards away from work. In Fairbanks, small-town living, spectacular natural beauty and endless recreation combine to create a one-of-a-kind place to live, work and play. 


Living in Fairbanks:

As the second largest city in Alaska, Fairbanks offers a unique blend of large-town amenities, breathtaking landscapes, and plenty of wide-open space, making this community one of the most special in the country. With a rich history and plentiful diversity, Fairbanks is proud to be called the Golden Heart City, and only once you visit will you understand the name to be true. 

  • No state income tax and no sales tax.
  • Second largest city in Alaska at 100,000 residents.
  • College Town – the University of Alaska Fairbanks, UAF Community & Technical College
  • Military Community – Ft. Wainwright Army Post & Eielson Air Force Base.
  • 15 Elementary Schools | 4 Middle Schools | 4 High Schools | 10 District “Schools of Choice”| robust youth sports programs

Summer activities: Midnight sun, hiking, fishing, camping, gold panning, kayaking, berry picking, rafting, rock climbing, recreational flying, community-wide festivals, live music, and events.

Winter activities: Northern lights, skiing, snowshoeing, snowmobiling, hockey, curling, ice fishing, dog mushing, ice climbing, hunting, ice art, word class hot springs, community-wide art shows, and festivals etc.

Responsibilities
  • Partners with Finance and other key stakeholders to continually monitor and analyze financial reimbursement trends and healthcare changes within the national and Alaska marketplace. Analyzes the market as it relates to provider incentive programs. Evaluates the impact to Foundation Health and works collaboratively with key stakeholders to determine the appropriate approach related to CMS’s QPP or other payor’s value based programs.
  • Serves as FHP’s subject matter expert on CMS QPP programs for both hospital and providers. Stays current with all related regulation changes, and understands their impact on operations, finance, as well as any needed EMR configurations or applications. Advises FHP leadership and stakeholders to the changing regulations and the identification of any major organizational process impacts.
  • Collaborates with key stakeholders to establish workflows and processes for strong reimbursement or decreased penalties with operational, clinical and financial leadership. Ensures clear accountability for success, optimizing maximum incentives and minimizing penalties. Facilitates consensus for workflow standardization as necessary.
  • Partners with educational and communication business owners across the system to communicate initial decision, workflows, and processes along with initial and ongoing education for employees, providers and leadership.
  • Facilitates the eligible hospital and eligible provider performance on metrics tied to incentive programs. Creates and manages associated performance dashboards. Creates and implements appropriate action plans to meet targets, as needed. Partners with Clinical Informatics, clinical leaders, and physicians to optimize workflows to meet program measures. Includes the development of project plans, charters, and the organization of cross functional teams.
  • Assists the Finance and Quality Departments with the submission of results to the appropriate governmental agencies.
  • Proactively identifies regulation changes that will require EMR or other software changes, advising Information Technology and Finance of the needs in advance with budget timing in mind. Partners with IT for necessary software system set up and data migrations. Generates reports and communicates with IT for any data reporting needs.
Qualifications
  • Requires extensive sitting with periodic standing and walking.
  • May be required to lift up to 20 pounds.
  • Requires significant use of personal computer, phone and general office equipment.
  • Needs adequate visual acuity, ability to grasp and handle objects.
  • Needs ability to communicate effectively through reading, writing, and speaking in person or on telephone.
  • May require off-site travel

Preferred Qualifications

  • Additional related education and/or experience preferred.

Skills Required

  • Extensive sitting with periodic standing and walking
  • Ability to lift up to 20 pounds
  • Significant use of a personal computer, telephone, and general office equipment
  • Adequate visual acuity and ability to grasp and handle objects
  • Effective communication through reading, writing, in-person speaking, and telephone communication
  • Additional related education and/or experience
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The Company
546 Employees
Year Founded: 1972

What We Do

Foundation Health Partners (FHP) is an independent, community-owned health system in Fairbanks, Alaska. It operates Tanana Valley Clinic, Fairbanks Memorial Hospital, and Denali Center, serving patients across Alaska’s Interior. The organization provides hospital, outpatient, specialty, emergency, and short- and long-term care, combining experienced professionals, advanced technology, and best practices to deliver compassionate, high-quality care for patients and residents throughout the region.

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